The issues related to the country specific implementation of the intervention might explain some of the variation be- tween the countries. However, this study suggests that large country variations in feeding were present from birth. For example, it is known that formula feeding had a high ac- ceptance in South Africa [34], whereas this is not the case in Uganda and Burkina Faso and large areas of sub-Saharan Africa where it is considered unaffordable, unacceptable and unfeasible [35]